By Michele Lerner

Originally published February 2007

Dr. Keith Horvath (front right) and his team perform a coronary bypass at the new NIH Heart Center at Suburban Hospital. The center opened in May. Photo by John Keith

    

     “All three institutions gain through this collaboration because of the research and the ability to oversee clinical outcomes of that research,” said Dr. Edward Miller, dean and CEO of Johns Hopkins Medicine.

     Suburban Hospital and its partners renovated a section of the hospital to develop the state-of-the-art cardiology center and cardiothoracic center, spending $16.6 million and hiring more than 80 new staff members.

     The Heart Center will bring together the research capabilities of Bethesda-based NIH, with the training programs of Johns Hopkins and the clinical expertise of the staff of Suburban Hospital.

     “Having the Heart Center at the back door of NIH allows Suburban to push the envelope on the clinical side,” Miller said.

     Dr. Keith Horvath, chief of cardiothoracic surgery at Suburban, believes the fact that it is a community hospital contributes to the program’s success.

     “There is no way that even one-third of what’s been accomplished could have been done at a larger hospital,” said Horvath. “Getting something changed at a larger institution can be like getting an aircraft carrier turned around.”

     The three institutions formally began their cooperation in July 1996, when NIH began considering reopening its heart surgery program, which had ended in 1990 due to low patient volume, high costs and a shift in scientific priorities, according to Dr. Elizabeth Nabel, director of the National Heart, Lung and Blood Institute.

     At the same time, Suburban Hospital was pursuing a new cardiac surgery initiative. But the initiative hit some bumps along the way.

     The 10-year effort began with an initial application from Suburban Hospital and other institutions for a cardiac surgery program. In a competitive process, the Maryland Health Care Commission awarded the program to Suburban Hospital, but later rescinded it after a series of lawsuits from other hospitals.

     As a result, the Commission rewrote its policy and, again, awarded the program to Suburban Hospital in July 2005. Two additional lawsuits were eventually dismissed.

     The renovations to the hospital began immediately.

     New facilities at the NIH Heart Center include two cardiac operating centers which are digitally integrated so that all surgery staff members can view operations as they proceed, and three new state-of-the-art catheterization labs.

Dr. Kenneth Kent (left) inserts a stent into a patient’s coronary artery during a procedure at the NIH Heart Center. Photo by John Keith

     Officials expect 200 open heart and thoracic surgeries and 750 catheterizations and angioplasties to be performed annually at the center. Plans also include expanding the services to treat arrhythmia and ablation, as well as developing additional in-patient units for cardiac patients.

     “While Suburban provides the clinical expertise, NIH provides the brain trust and the financial support for the center,” said Dr. Kenneth Kent, chief of cardiology at Suburban.

     Kent said that Johns Hopkins’ contribution is identifying surgeons and training the staff. Cardiac fellowships and surgeons will continue to rotate through the three institutions.

     Staffing the NIH Heart Center was a major challenge requiring a local and national search, according to Melody Knapp, a registered nurse and administrator of the Cardiovascular Service Line at Suburban.

     Experienced clinical staff members specializing in cardiac care came from nationally known heart centers at Washington Hospital Center, Inova and Washington Adventist Hospital, as well as other locations. All cardiac surgery staff spent one month in a clinical orientation program at Johns Hopkins, said Knapp.

     Three major areas of research are underway at the Heart Center, according to Horvath, including cellular surgery which looks at stem cell transplantation; MRI-guided robotic surgery which uses MRI as the eyes of the surgeon for operations such as valve replacements; and xeno transplantation, anticipated to be the future of cardiac surgery. Xeno transplantation will transplant entire organs of other species into humans rather than pieces of organs.

     “The great thing about this new program is that we can take the best of the best in terms of research and inculcate them into a new approach for what is best for the patients,” said Horvath. “The cutting edge research and techniques developed at NIH are all beneficial to today’s patients and will have a dramatic impact and support for future patients.” <